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Addiction Medicine pp 1459–1486Cite as

Disability and Addiction

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Abstract

This chapter addresses two main themes in disability and addiction: (1) the definition of disability in several different contexts as it pertains to addiction and (2) the short- and long-term effects of drugs and alcohol that may cause disabilities. The discussion of the first theme focuses on the term “disability” as defined in the legal, clinical, and rehabilitation communities, with a concentration on laws and practices in the United States. Included here is a detailed description of the Americans with Disabilities Act as it pertains to people who are currently using substances and those in recovery from substance use, including a history of rules, regulations, and legal challenges and an update on the current state of the regulatory atmosphere. The discussion also touches on rules that determine distribution of Social Security Administration disability benefits, as well as the implications of the various definitions of disability for treatment, employment, and medical coverage for people with substance use disorders. Next, we turn to the ramifications of the understanding of disability and related policies for substance abuse treatment, closing with an assessment of the impact of recent legislation requiring parity in mental health and addiction services. Key discussion points for the second theme include how addictive disorders may cause or contribute to the development of disabilities. This portion examines the short- and long-term effects of the different classes of drugs of abuse, centering on neurological, physical, sensory, and functional impairment. The classes currently listed by the National Institute on Drug Abuse as drugs of abuse include illegal drugs such as cocaine, heroin, marijuana, and methamphetamine; legal drugs such as alcohol; legal substances used as drugs such as inhalants and anabolic steroids; and prescription medications. The discussion also addresses the neurobiological underpinnings of the impairments that may result from the abuse of drugs in each class. Specific areas described are the greater risk of substance abuse in people with preexisting mental and physical disabilities; the increased risk for people who abuse substances of contracting potentially disabling or potentially fatal infectious diseases such as human immunodeficiency virus, tuberculosis, and hepatitis C virus; and the risk of addiction and disability for children born to mothers with addictions.

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Acknowledgments

The author would like to acknowledge the efforts of Clarinda Mac Low and Susan Hills, Ph.D., in the development of this chapter.

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  1. Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, Rockville, MD, USA

    Charlene E. Le Fauve

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    Bankole A. Johnson

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Le Fauve, C.E. (2010). Disability and Addiction. In: Johnson, B. (eds) Addiction Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0338-9_73

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